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Toward ReconstitutionWhat happens when the right to be heard replaces the obligation to respond. Author: Melissa Cosgrove
What happens when the right to be heard replaces the obligation to respond? Toward Reconstitution is a 13-episode podcast exploring the gap between what we ask of our government and what power can be made to do. Hosted by independent scholar Melissa Cosgrove, the series examines how modern institutions preserve the appearance of public participation while systematically decoupling accountability. Through contemporary cases, legal analysis, and political history, Toward Reconstitution asks what it would take to build a constitutional order bound by relational integritywhere rights place duties on those with power and harm creates an obligation to repair. Language: en Genres: Government, News, Politics Contact email: Get it Feed URL: Get it iTunes ID: Get it Trailer: |
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When Participation Becomes Labor
Episode 2
Saturday, 12 September, 2026
In the winter of 2023, Kristin Fortner mailed Arkansas the paperwork required to renew her Medicaid. When the state later told her she hadn’t renewed, she submitted the form again in person. Her coverage still ended. She found out at a Walgreens counter, when the Suboxone prescription she expected Medicaid to cover suddenly cost $380. Episode 2 of Toward Reconstitution follows Kristin’s story into the Medicaid unwinding, when states reviewed the eligibility of tens of millions of people after pandemic-era continuous enrollment ended. More than 25 million people were disenrolled in KFF’s near-final count, and 69 percent of those disenrollments were procedural, meaning coverage ended without a determination that the person was ineligible. Later federal data counted 26.8 million disenrollments out of 89 million completed redeterminations. The episode asks what participation means when the work of correcting government’s mistakes keeps falling back on the person affected by them. It introduces answerability as something more demanding than simply giving people a form, a phone number, or somewhere to appeal, and looks at what changes when institutions can recognize recurring failures instead of forcing each person to fight through them alone.Sources and further readingThe Washington Post — Amy Goldstein, “Nearly 4 million in U.S. cut from Medicaid, most for paperwork reasons.” The original reporting on Kristin and Ryan Fortner, including the lost renewal, the termination of their Medicaid coverage, the $380 Suboxone prescription, and Kristin’s attempts to get the problem corrected.Read the Washington Post reportingKFF — Medicaid Enrollment & Unwinding Tracker. Near-final state data showing more than 25 million disenrollments, with 69 percent of disenrollments occurring for procedural or paperwork reasons and 61 percent of renewals completed automatically through ex parte review.View the KFF trackerKFF — An Examination of Medicaid Renewal Outcomes and Enrollment Changes at the End of the Unwinding. Analysis of the final stages of the unwinding, including procedural disenrollment rates, automatic renewals, and wide variation among states.Read the KFF analysisKFF — Survey of Medicaid Unwinding. National survey research on what Medicaid enrollees experienced while trying to renew coverage, including problems completing the process and interruptions in access to care.Read the KFF surveyU.S. Government Accountability Office — Medicaid and Children’s Health Insurance: Disenrollments After COVID-19 Varied Across States and Populations. Federal analysis of 89 million completed redeterminations, 26.8 million disenrollments, state variation, and CMS efforts to identify and correct improper disenrollments.Read the GAO report
